Back Pain During Pregnancy

Pregnancy can be a wonderful time for a woman, but there are a number of side effects that can disrupt your daily routine. You should set aside plenty of time to rest during the second half of your pregnancy to avoid common issues like back pain that pregnancy can cause. Asking family and friends for help with daily chores can help you stay off your feet. However, if you experience issues with your back aching, come in to our Goose Creek clinic for safe and conservative treatments to relieve the strain.

What is Back Pain During Pregnancy?

Many women already have some form of mild or generalized back pain before they become pregnant. Even if your back is free of pain, the extra weight of the baby can put a lot of wear and tear on the spine. Hormonal changes also contribute to the likeliness of back pain. There is no need to live with chronic irritation after your baby has been born if you seek treatment when the pain first appears.

Back Pain During Pregnancy Symptoms:

If the pregnancy itself is causing the pain, it is likely to be moderate to mild and localized in one region or another. Most of our patients report:

• Lumbar pain and inflammation in the lower back

• Irritation deep in the pelvis or through the groin and rear

• Aching along the spine or in the legs and shoulders

• Loss of flexibility and stiffness that makes it hard to bend or twist.

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Cause of Back Pain During Pregnancy

There are numerous bodily changes that evolve as your pregnancy progresses. The enlargement of the uterus can lead to muscle pain or pressure on key nerves. The most common causes of back pain during pregnancy include:

• The 30 pounds or more that most women gain

• Stooping and other poor posture changes due to the extra weight

• Loosening of spinal ligaments due to hormonal changes

• Separation of muscles in the pelvis and abdominal to accommodate the growing fetus

• Excessive exercise or time spent on the feet due to work

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Back Pain During Pregnancy Risks

Some women experience back during during pregnancy no matter what they do, which is also the case for morning sickness and general fatigue. There are ways to avoid unnecessary damage to your back by taking care of yourself during the second and third trimester. Stick with good practices like:

• Wearing low heeled shoes that offer plenty of arch support

• Don’t stand for more than an hour at a time if possible

• Avoid lifting heavy objects, especially when your center of gravity shifts

• Sleep on your side to support the weight

• Try sleeping on a firmer mattress or with a board below you to support the spine

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Back Pain During Pregnancy Treatment Option

It can be risky to take painkillers when you are pregnant because most drugs can affect the fetus. Look for alternatives at our Goose Creek office that include:

• Exercise plans that help you properly alternative rest and activity for a stronger spine

• Chiropractic manipulation to restore the proper alignment of your back

• Recommendations for application of heat or cold to ease the pain

More good news: Unless you had chronic backaches before you got pregnant, your pain will likely ease gradually before you give birth.

Meanwhile, there are many things you can do to treat low back pain or make it rarer and milder:

• Exercise

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• . Regular exercise strengthens muscles and boosts flexibility. That can ease the stress on your spine. Safe exercises for most pregnant women include walking, swimming, and stationary cycling. Your doctor or physical therapist can recommend exercises to strengthen your back and abdomen.

• Heat and Cold.

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• Applying heat and cold to your back may help. If your health care provider agrees, start by putting cold compresses (such as a bag of ice or frozen vegetables wrapped in a towel) on the painful area for up to 20 minutes several times a day. After two or three days, switch to heat — put a heating pad or hot water bottle on the painful area. Be careful not to apply heat to your abdomen during pregnancy.

• Improve your posture

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• . Slouching strains your spine. So using proper posture when working, sitting, or sleeping is a good move. For example, sleeping on your side with a pillow between the knees will take stress off your back. When sitting at a desk, place a rolled-up towel behind your back for support; rest your feet on a stack of books or stool and sit up straight, with your shoulders back. Wearing a support belt may also help.

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• Counseling.

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• If back pain is related to stress, talking to a trusted friend or counselor may be helpful.

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• Acupuncture.

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• Acupuncture is a form of Chinese medicine in which thin needles are inserted into your skin at certain locations. Studies have shown that acupuncture can be effective in relieving low back pain during pregnancy. Check with your health care provider if you’re interested in trying it.

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• Chiropractic.

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• When performed correctly, chiropractic manipulation of the spine can be safe during pregnancy, but consult with your doctor before seeking chiropractic care.

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Make Pregnancy A Comfortable Experience

Visiting Back2Health Physical Medicine could help you finish up the rest of your pregnancy with less pain and more energy. If you seek back support before symptoms even set in, you may get all the way through the nine months without irritation or inflammation. Seek immediate treatment if you suddenly experience sharp pains in the spine or cramping that won’t stop. This could indicate a more serious condition like osteoporosis or even premature labor.

Pregnancy complications

• Health problems before pregnancy

• Pregnancy related problems

• Infections during pregnancy

• When to call the doctor

• More information on pregnancy complications

Complications of pregnancy are health problems that occur during pregnancy. They can involve the mother’s health, the baby’s health, or both. Some women have health problems before they become pregnant that could lead to complications. Other problems arise during the pregnancy. Keep in mind that whether a complication is common or rare, there are ways to manage problems that come up during pregnancy.

Health problems before pregnancy:

Before pregnancy, make sure to talk to your doctor about health problems you have now or have had in the past. If you are receiving treatment for a health problem, your doctor might want to change the way your health problem is managed. Some medicines used to treat health problems could be harmful if taken during pregnancy. At the same time, stopping medicines that you need could be more harmful than the risks posed should you become pregnant. Be assured that you are likely to have a normal, healthy baby when health problems are under control and you get good prenatal care.

Health problems before pregnancy

Condition How it can affect pregnancy Where to learn more

Asthma

Poorly controlled asthma may increase risk ofpreeclampsia, poor weight gain in the fetus, preterm birth, cesarean birth, and other complications. If pregnant women stop using asthma medicine, even mild asthma can become severe. • Lung diseases fact sheet

Depression

Depression that persists during pregnancy can make it hard for a woman to care for herself and her unborn baby. Having depression before pregnancy also is a risk factor for postpartum depression.

• Depression fact sheet

• Depression during and after pregnancy fact sheet

Diabetes

High blood glucose (sugar) levels during pregnancy can harm the fetus and worsen a woman’s long-termdiabetes complications. Doctors advise getting diabetes under control at least three to six months before trying to conceive. • Diabetes fact sheet

Eating disorders

Body image changes during pregnancy can cause eating disorders to worsen. Eating disorders are linked to many pregnancy complications, including birth defects andpremature birth. Women with eating disorders also have higher rates of postpartum depression.

• Anorexia nervosa fact sheet

• Bulimia nervosa fact sheet

Epilepsy and otherseizure disorders Seizures during pregnancy can harm the fetus, and increase the risk of miscarriage or stillbirth. But using medicine to control seizures might cause birth defects. For most pregnant women with epilepsy, using medicine poses less risk to their own health and the health of their babies than stopping medicine. • About Epilepsy

High blood pressure

Having chronic high blood pressure puts a pregnant woman and her baby at risk for problems. Women with high blood pressure have a higher risk of preeclampsiaand placental abruption (when the placenta separates from the wall of the uterus). The likelihood of preterm birth and low birth weight also is higher. • National high blood pressure education program

HIV

HIV can be passed from a woman to her baby during pregnancy or delivery. Yet this risk is less than 2 percent if a woman takes certain HIV medicines during pregnancy. Women who have HIV and want to become pregnant should talk to their doctors before trying to conceive. Good prenatal care will help protect a woman’s baby from HIV and keep her healthy. • HIV/AIDS

Migraine

Migraine symptoms tend to improve during pregnancy. Some women have no migraine attacks during pregnancy. Certain medicines commonly used to treat headaches should not be used during pregnancy. A woman who has severe headaches should speak to her doctor about ways to relieve symptoms safely. • Migraine fact sheet

Overweight andObesity

Recent studies suggest that the heavier a woman is before she becomes pregnant, the greater her risk of a range of pregnancy complications, includingpreeclampsia and preterm delivery. Overweight and obese women who lose weight before pregnancy are likely to have healthier pregnancies. • Overweight, obesity, and weight loss fact sheet

Sexually transmitted infections (STIs)

Some STIs can cause early labor, a woman’s water to break too early, and infection in the uterus after birth. Some STIs also can be passed from a woman to her baby during pregnancy or delivery. Some ways STIs can harm the baby include: low birth weight, dangerous infections, brain damage, blindness, deafness, liver problems, or stillbirth.

• Sexually transmitted infections fact sheet

Thyroid disease

Uncontrolled hyperthyroidism (overactive thyroid) can be dangerous to the mother and cause health problems such as heart failure and poor weight gain in the fetus. Uncontrolled hypothyroidism (underactive thyroid) also threatens the mother’s health and can cause birth defects. • Graves’ disease fact sheet

• Hashimoto’s disease fact sheet

Uterine fibroids

Uterine fibroids are not uncommon, but few cause symptoms that require treatment. Uterine fibroids rarely cause miscarriage. Sometimes, fibroids can causepreterm or breech birth. Cesarean delivery may be needed if a fibroid blocks the birth canal. • Uterine fibroids fact sheet

Sometimes pregnancy problems arise — even in healthy women. Some prenatal tests done during pregnancy can help prevent these problems or spot them early. Use this chart to learn about some common pregnancy complications. Call your doctor if you have any of the symptoms on this chart. If a problem is found, make sure to follow your doctor’s advice about treatment. Doing so will boost your chances of having a safe delivery and a strong, healthy baby.

Health problems during pregnancy

Problem Symptoms Treatment

Anemia – Lower than normal number of healthy red blood cells • Feel tired or weak

• Look pale

• Feel faint

• Shortness of breath Treating the underlying cause of the anemia will help restore the number of healthy red blood cells. Women with pregnancy related anemia are helped by taking iron and folic acid supplements. Your doctor will check your iron levels throughout pregnancy to be sure anemia does not happen again.

Depression – Extreme sadness during pregnancy or after birth (postpartum) • Intense sadness

• Helplessness and irritability

• Appetite changes

• Thoughts of harming self or baby Women who are pregnant might be helped with one or a combination of treatment options, including:

• Therapy

• Support groups

• Medicines

A mother’s depression can affect her baby’s development, so getting treatment is important for both mother and baby. Learn more aboutdepression during and after pregnancy.

Ectopic (ek-TOP-ihk) pregnancy – When a fertilized egg implants outside of theuterus, usually in the fallopian tube

• Abdominal pain

• Shoulder pain

• Vaginal bleeding

• Feeling dizzy or faint With ectopic pregnancy, the egg cannot develop. Drugs or surgery is used to remove the ectopic tissue so your organs are not damaged.

Fetal problems – Unborn baby has a health issue, such as poor growth or heart problems • Baby moving less than normal (Learn how tocount your baby’s movements on our Prenatal care and tests page.)

• Baby is smaller than normal for gestational age

• Some problems have no symptoms, but are found with prenatal tests Treatment depends on results of tests to monitor baby’s health. If a test suggests a problem, this does not always mean the baby is in trouble. It may only mean that the mother needs special care until the baby is delivered. This can include a wide variety of things, such as bed rest, depending on the mother’s condition. Sometimes, the baby has to be delivered early.

Gestational diabetes – Too high blood sugar levels during pregnancy • Usually, there are no symptoms. Sometimes, extreme thirst, hunger, or fatigue

• Screening test shows high blood sugar levels Most women with pregnancy related diabetes can control their blood sugar levels by a following a healthy meal plan from their doctor. Some women also need insulin to keep blood sugar levels under control. Doing so is important because poorly controlled diabetes increases the risk of:

• Preeclampsia

• Early delivery

• Cesearean birth

• Having a big baby, which can complicate delivery

• Baby born with low blood sugar, breathing problems, and jaundice

High blood pressure(pregnancy related) – High blood pressure that starts after 20 weeks of pregnancy and goes away after birth • High blood pressure without other signs and symptoms ofpreeclampsia

The health of the mother and baby are closely watched to make sure high blood pressure is not preeclampsia.

Hyperemesis gravidarum(HEYE-pur-EM-uh-suhss grav-uh-DAR-uhm) (HG) – Severe, persistent nausea and vomiting during pregnancy — more extreme than “morning sickness” • Nausea that does not go away

• Vomiting several times every day

• Weight loss

• Reduced appetite

• Dehydration

• Feeling faint or fainting Dry, bland foods and fluids together is the first line of treatment. Sometimes, medicines are prescribed to help nausea. Many women with HG have to be hospitalized so they can be fed fluids and nutrients through a tube in their veins. Usually, women with HG begin to feel better by the 20th week of pregnancy. But some women vomit and feel nauseated throughout all three trimesters.

Miscarriage – Pregnancy loss from natural causes before 20 weeks. As many as 20 percent of pregnancies end in miscarriage. Often, miscarriage occurs before a woman even knows she is pregnant Signs of a miscarriage can include:

• Vaginal spotting or bleeding*

• Cramping or abdominal pain

• Fluid or tissue passing from the vagina

* Spotting early in pregnancy doesn’t mean miscarriage is certain. Still, contact your doctor right away if you have any bleeding. In most cases, miscarriage cannot be prevented. Sometimes, a woman must undergo treatment to remove pregnancy tissue in the uterus. Counseling can help with emotional healing. See our section onPregnancy loss.

Placenta previa – Placentacovers part or entire opening ofcervix inside of the uterus

• Painless vaginalbleeding during second or third trimester

• For some, no symptoms If diagnosed after the 20th week of pregnancy, but with no bleeding, a woman will need to cut back on her activity level and increase bed rest. If bleeding is heavy, hospitalization may be needed until mother and baby are stable. If the bleeding stops or is light, continued bed rest is resumed until baby is ready for delivery. If bleeding doesn’t stop or if preterm labor starts, baby will be delivered by cesarean section.

Placental abruption – Placentaseparates from uterine wall before delivery, which can mean the fetus doesn’t get enough oxygen. • Vaginal bleeding

• Cramping, abdominal pain, and uterine tenderness When the separation is minor, bed rest for a few days usually stops the bleeding. Moderate cases may require complete bed rest. Severe cases (when more than half of the placenta separates) can require immediate medical attention and early delivery of the baby.

Preeclampsia (pree-ee-CLAMP-see-uh) – A condition starting after 20 weeks of pregnancy that causes high blood pressure and problems with the kidneys and other organs. Also called toxemia. • High blood pressure

• Swelling of hands and face

• Too much protein in urine

• Stomach pain

• Blurred vision

• Dizziness

• Headaches The only cure is delivery, which may not be best for the baby. Labor will probably be induced if condition is mild and the woman is near term (37 to 40 weeks of pregnancy). If it is too early to deliver, the doctor will watch the health of the mother and her baby very closely. She may need medicines and bed rest at home or in the hospital to lower her blood pressure. Medicines also might be used to prevent the mother from having seizures.

Preterm labor – Going into labor before 37 weeks of pregnancy • Increased vaginaldischarge

• Pelvic pressure and cramping

• Back pain radiating to the abdomen

• Contractions

Medicines can stop labor from progressing. Bed rest is often advised. Sometimes, a woman must deliver early. Giving birth before 37 weeks is called “preterm birth.” Preterm birth is a major risk factor for future preterm births.

Infections during pregnancy

During pregnancy, your baby is protected from many illnesses, like the common cold or a passing stomach bug. But some infections can be harmful to your pregnancy, your baby, or both. This chart provides an overview of infections that can be harmful during pregnancy. Learn the symptoms and what you can do to keep healthy. Easy steps, such as hand washing, practicing safe sex, and avoiding certain foods, can help protect you from some infections.

Infections during pregnancy

Infection Symptoms Prevention and treatment

Bacterial vaginosis (BV)

A vaginal infection that is caused by an overgrowth of bacteria normally found in the vagina.

BV has been linked topreterm birth and low birth weight babies.

• Grey or whitish discharge that has a foul, fishy odor

• Burning when passing urine or itching

• Some women have no symptoms How to prevent BV is unclear. BV is not passed through sexual contact, although it is linked with having a new or more than one sex partner.

Women with symptoms should be tested for BV.

Antibiotics are used to treat BV.

Cytomegalovirus (SEYE-toh-MEG-uh-loh VEYE-ruhss) (CMV)

A common virus that can cause disease in infants whose mothers are infected with CMV during pregnancy. CMV infection in infants can lead to hearing loss, vision loss, and other disabilities. • Mild illness that may include fever, sore throat, fatigue, and swollen glands

• Some women have no symptoms Good hygiene is the best way to keep from getting CMV.

No treatment is currently available. But studies are looking at antiviral drugs for use in infants. Work to create a CMV vaccine also is underway.

Group B strep (GBS)

Group B strep is a type of bacteria often found in thevagina and rectum of healthy women. One in four women has it. GBS usually is not harmful to you, but can be deadly to your baby if passed during childbirth. • No symptoms You can keep from passing GBS to your baby by getting tested at 35 to 37 weeks. This simply involves swabbing the vagina and rectum and does not hurt.

If you have GBS, an antibiotic given to you during labor will protect your baby from infection. Make sure to tell the labor and delivery staff that you are a group B strep carrier when you check into the hospital.

Hepatitis B virus (HBV)

A viral infection that can be passed to baby during birth. Newborns that get infected have a 90 percent chance of developing lifelong infection. This can lead to liver damage and liver cancer. A vaccine can keep newborns from getting HBV. But 1 in 5 newborns of mothers who are HBV positive don’t get the vaccine at the hospital before leaving. There may be no symptoms. Or symptoms can include:

• Nausea, vomiting, and diarrhea

• Dark urine and pale bowel movements

• Whites of eyes or skin looks yellow Lab tests can find out if the mother is a carrier of hepatitis B.

You can protect your baby for life from HBV with the hepatitis B vaccine, which is a series of three shots:

• First dose of hepatitis B vaccine plus HBIG shot given to baby at birth

• Second dose of hepatitis B vaccine given to baby at 1-2 months old

• Third dose of hepatitis B vaccine given to baby at 6 months old (but not before 24 weeks old)

Influenza (flu)

Flu is a common viral infection that is more likely to cause severe illness in pregnant women than in women who are not pregnant. Pregnant woman with flu also have a greater chance for serious problems for their unborn baby, including premature labor and delivery. • Fever (sometimes) or feeling feverish/chills

• Cough

• Sore throat

• Runny or stuffy nose

• Muscle or body aches

• Headaches

• Feeling tired

• Vomiting and diarrhea (sometimes) Getting a flu shot is the first and most important step in protecting against flu. The flu shot given during pregnancy is safe and has been shown to protect both the mother and her baby (up to 6 months old) from flu. (The nasal spray vaccine should not be given to women who are pregnant.)

If you get sick with flu-like symptoms call your doctor right away. If needed, the doctor will prescribe an antiviral medicine that treats the flu.

Listeriosis (lih-steer-ee-OH-suhss)

An infection with the harmful bacteria called listeria. It is found in some refrigerated and ready-to-eat foods. Infection can cause early delivery ormiscarriage.

• Fever, muscle aches, chills

• Sometimes diarrhea or nausea

• If progresses, severe headache and stiff neck Avoid foods that can harbor listeria.

Antibiotics are used to treat listeriosis.

Learn more from our Pregnancy food don’ts – Print-and-go guide (PDF, 126 KB).

Parvovirus B19 (fifth disease)

Most pregnant women who are infected with this virus do not have serious problems. But there is a small chance the virus can infect the fetus. This raises the risk of miscarriageduring the first 20 weeks of pregnancy. Fifth disease can cause severe anemia in women who have red blood cell disorders like sickle celldisease or immune system problems. • Low-grade fever

• Tiredness

• Rash on face, trunk, and limbs

• Painful and swollen joints No specific treatment, except for blood transfusions that might be needed for people who have problems with their immune systems or with red blood cell disorders. There is no vaccine to help prevent infection with this virus.

Sexually transmitted infection (STI)

An infection that is passed through sexual contact. Many STIs can be passed to the baby in the womb or during birth. Some effects include stillbirth, low birth weight, and life-threatening infections. STIs also can cause a woman’s water to break too early or preterm labor.

• Symptoms depend on the STI. Often, a woman has no symptoms, which is why screening for STIs during pregnancy is so important.

• For more information, see our Sexually transmitted infections fact sheet.

STIs can be prevented by practicing safe sex. A woman can keep from passing an STI to her baby by being screened early in pregnancy.

Treatments vary depending on the STI. Many STIs are treated easily withantibiotics.

Toxoplasmosis (TOK-soh-plaz-MOH-suhss)

This infection is caused by a parasite, which is found in cat feces, soil, and raw or undercooked meat. If passed to an unborn baby, the infection can cause hearing loss, blindness, or intellectual disabilities. • Mild flu-like symptoms, or possibly no symptoms. You can lower your risk by:

• Washing hands with soap after touching soil or raw meat

• Washing produce before eating

• Cooking meat completely

• Washing cooking utensils with hot, soapy water

• Not cleaning cats’ litter boxes

Medicines are used to treat a pregnant woman and her unborn baby. Sometimes, the baby is treated with medicine after birth.

Urinary tract infection(UTI)

Bacterial infection in urinary tract. If untreated, it can spread to the kidneys, which can cause preterm labor.

• Pain or burning when urinating

• Frequent urination

• Pelvis, back, stomach, or side pain

• Shaking, chills, fever, sweats UTIs are treated with antibiotics.

Yeast infection

An infection caused by an overgrowth of bacteria normally found in thevagina. Yeast infections are more common during pregnancy than in other times of a woman’s life. They do not threaten the health of your baby. But they can be uncomfortable and difficult to treat in pregnancy. • Extreme itchiness in and around the vagina

• Burning, redness, and swelling of the vagina and the vulva

• Pain when passing urine or during sex

• A thick, white vaginal discharge that looks like cottage cheese and does not have a bad smell Vaginal creams and suppositories are used to treat yeast infection during pregnancy.

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When to call the doctor

When you are pregnant don’t wait to call your doctor or midwife if something is bothering or worrying you. Sometimes physical changes can be signs of a problem.

Call your doctor or midwife as soon as you can if you:

• Are bleeding or leaking fluid from the vagina

• Have sudden or severe swelling in the face, hands, or fingers

• Get severe or long-lasting headaches

• Have discomfort, pain, or cramping in the lower abdomen

• Have a fever or chills

• Are vomiting or have persistent nausea

• Feel discomfort, pain, or burning with urination

• Have problems seeing or blurred vision

• Feel dizzy

• Suspect your baby is moving less than normal after 28 weeks of pregnancy (If you count less than 10 movements within two hours. Learn how to count your baby’s movements on our Prenatal care and tests page.)

• Have thoughts of harming yourself or your baby